The Symptoms of Morkie Hypoglycemia and How to Treat It

morkie sitting in grass

There is no dog more fun than a Morkie. Their high energy and playful personalities will keep you entertained, and their sweetness and cuddliness will keep you feeling warm and fuzzy all over.

Morkie Hypoglycemia Explained

But keep an eye out for a drop in that high energy, as it could be an indication of hypoglycemia or low blood sugar. Your Morkie dog is particularly at risk for this condition, as both sides of their parentage, the Maltese and the Yorkshire Terrier dog breeds, have a genetic predisposition for this disease.

The danger of hypoglycemia comes from the fact that the brain needs a steady supply of glucose to function. If your Morkie’s blood sugar drops too low, this can affect all neurological functions and can result in everything from disorientation to a coma.

Morkie puppies are particularly at risk for hypoglycemia because small-breed puppies have a higher metabolic rate and energy requirement relative to their body size than larger breed puppies. Also, they have not yet developed the energy stores which would allow them to maintain an adequate blood glucose level during long gaps in meals.

Causes of Hypoglycemia in Morkies

Inadequate Nutrition

The most direct cause of low blood sugar in Morkies is inadequate nutrition. This is always a particular concern for small dogs and even more so if your Morkie is particularly active, has too much time between meals, or does not eat before vigorous exercise.


Stress is another cause of hypoglycemia in Morkies. Stress causes your Morkie’s body to burn more sugar, so when stressors are present, maintaining a healthy blood sugar level becomes more difficult.


Diabetes treatment can also cause hypoglycemia. If your Morkie has diabetes, giving them too much insulin can easily lead to their blood sugar level becoming too low.

Congenital Portosystemic Liver Shunts

Morkie hypoglycemia can also result from underlying con­ditions such as a congenital portosystemic liver shunt. This deserves special consideration as the Yorkshire terrier breed is particularly prone to this condition. The portal vein brings blood from the gastrointestinal system, pancreas, and spleen and transports it to the liver, removing toxins and other byproducts. A portosystemic shunt happens when an abnormal connection forms between the portal vein and another vein, allowing blood to bypass the liver. In a Morkie puppy, this is usually a congenital condition or is present at birth.

morkie running through grass field

Addison’s disease

Addison’s disease happens when your Morkie’s adrenal glands fail to produce an adequate number of hormones. This can occur at any time in a dog‘s life and with either gender but is most common in young and middle-aged female dogs. The adrenal gland produces the most important hormones (steroids), particularly aldosterone and cortisol.

Generally, the cause of Addison’s disease in Morkies is unknown, though it is suspected that it usually results from an autoimmune process. It can also result from damage to the adrenal gland, which can be caused by a metastatic tumor, hemorrhage, infarction, or granulomatous disease. Regardless of the cause, when something interferes with the adrenal gland, your Morkie can no longer produce aldosterone and cortisol. Not enough cortisol results in insulin sensitivity, leading to low blood sugar.


Insulinoma, or insulin-producing tumors of the pancreas, results from a fast-growing cancer of the beta cells in the pancreas. The beta cells secrete insulin, which regulates glucose levels throughout the body’s cells. This leads to excessive insulin in the bloodstream. This causes glucose to become too low and so leads to hypoglycemia.

How Hypoglycemia Can Affect Your Morkie

Hypoglycemia in Morkies, especially in Morkie puppies, is very serious. It can lead to a severe decrease in your pup’s energy levels, seizures, and even death.

How hypoglycemia affects your pup will depend on the cause. If the cause is simple, like undernourishment, stress, or over-treatment of diabetes, quick action will allow your Morkie to resume a normal life. If it is the result of an underlying cause, such as a portosystemic liver shunt, Addison’s disease, or insulinoma, the quality of your Morkie’s life will depend on the effectiveness of the treatments for these conditions.

Life Expectancy of a Morkie With Hypoglycemia

The good news is, if your Morkie receives prompt care for their hypoglycemia, they should go on to live a long life. However, it can be fatal if hypoglycemia goes untreated, so get them the care they need without delay!

Signs That Your Morkie Might Have Hypoglycemia

The symptoms of hypoglycemia to look out for with your Morkie include low energy, loss of appetite, slow response to stimuli, lack of coordination, trembling, discolora­tion of skin and gums, dilated pupils, and weakness. More severe symptoms include tremoring, seizures, loss of consciousness, and coma.

Portosystemic Liver Shunt

Suppose a portosystemic liver shunt is the underlying cause of your Morkie’s hypoglycemia. In that case, you may also see stunted growth, poor muscle development, and strange behaviors such as disorientation, staring into space, circling, and head pressing. They may also drink and urinate excessively, vomit, and have diarrhea.

Addison’s Disease

If Addison’s disease is involved, it can be hard to pinpoint because of the wide range of symptoms. These may also increase and decrease over time. These symptoms include poor appetite, inability to respond appropriately to stress, depression, lethargy, weight loss, increased urination, increased thirst, dehydration, shaking, and weak pulse.

morkie laying on blanket


If your Morkie is suffering from insulinoma, the most common symptoms are physical collapse and loss of consciousness. Other symptoms include seizures and extreme weakness. The insulin is released periodically, so symptoms are inconsistent, and frequency is not predictable.

How To Care for and Treat Your Morkie for Hypoglycemia

If your Morkie has an attack of hypoglycemia, there are some things you can do at home. If your pup is conscious, try offering their favorite food. If your Morkie accepts the meal, this may be all you have to do. If your pup is in a stupor, unconscious, or in a coma, they should immediately be given sugar water, corn syrup, or Karo syrup. You do this by dabbing it on or under the tongue or gums to absorb the sugar directly into the bloodstream. Some vets recommend that owners of small dog breeds keep a glucose source always handy.

After this, you should wrap your Morkie in a blanket, as an attack of hypoglycemia will leave them with a lowered body temperature, and then take your Morkie directly to the vet. Once there, your pup will be warmed and their blood sugar level checked. If necessary, dextrose will be intravenously infused into their bloodstream. This will revive your Morkie very quickly.

Inadequate Nutrition

If the vet decides inadequate nutrition is to blame, they will want your Morkie to begin eating normally before they can go home. They will also advise you on properly feeding your Morkie and help you develop a dietary plan to avoid a reoccurrence of hypoglycemia.


If, after getting your Morkie home, you conclude that stress is a factor in their hypoglycemia, you should closely monitor their behavior. Subtle signs that your Morkie might be stressed include yawning (unless they’re tired), panting, pacing back and forth, pinning their ears back, and dilated pupils. More obvious signs may include loss of appetite, backing away from someone or a situation, tucking their tail between their legs, cowering, trembling, or shivering (when they’re not cold or excited).

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One of the best things you can do to reduce their stress is to give them lots of exercise. Brisk walks, swimming, and playing fetch are all great options.

Being a small dog, your Morkie may experience separation anxiety. If this is the case, you might want to consider crate training. Having their own cozy, personal space will help them relax when you are gone, and having them crate-trained will come in handy when you want to take your buddy on a trip! It’s always a good idea to put a security blanket in the crate and their favorite toy to help them feel even more at home, and hopefully, their separation anxiety will go away.

You may find that your Morkie responds well to certain calming noises. Classical music often does the trick. You could consider leaving the TV on when you are away, too.

And of course, don’t be a form of stress yourself! Our lives are often too busy these days, but you don’t want that to affect your pup. Always try to be calm and reassuring with your Morkie. You may find it’s the best therapy for you as well!

Over-Treatment of Diabetes

If your dog has diabetes, your vet will immediately consider whether your pup is receiving too much insulin and whether this could be causing their hypoglycemia. If this turns out to be the case, the solution will be to adjust the amount of insulin they are taking.

Portosystemic Liver Shunts

If your vet suspects a portosystemic liver shunt may be to blame for your Morkie’s hypoglycemia, they will conduct several tests. These include a complete blood count (CBC) test and serum chemistries to test for anemia and smaller than normal red blood cells. Most dogs with liver shunts also have higher than usual bile acids, so that they may conduct a bile acid test as well. Your vet may also want to do a portography, which is an X-ray showing the blood vessels going to or bypassing the liver. This is done using a dye injected directly into the portal vein.

morkie sitting in snow


If your vet concludes that your Morkie suffers from a portosystemic liver shunt, this condition can usually be stabilized with a prescribed diet. Dogs with shunts have trouble breaking down protein. Your vet will most likely recommend a dog food that is lower in protein than typical commercial diets, but that still has just enough protein to meet their needs. Egg, dairy, and soy protein are less likely to cause them problems than meat or fish-based dog food.

You may also want to consider a low-protein home-cooked diet. This should be designed by a board-certified veterinary nutritionist with experience managing dogs with shunts. Once approved, your pup will love watching you cook for them!

The good news is, a liver shunt doesn’t have to mean the end of treats! You want to avoid meat-based treats like jerky, rawhides, bully sticks, and pig ears, but meat-free dog biscuits, human treats such as animal crackers, breakfast cereal, non-toxic fruits, and vegetables should be just fine.


Most likely, your vet will also prescribe some medications. The goal of these medications is to increase protein tolerance and reduce the number of toxins that are produced and absorbed in the large intestines. Other than the medications, your vet will probably also recommend giving your dog a sugar called lactulose. This sugar changes the pH in the large intestines, decreasing the absorption of toxins and inhibiting toxin-producing bacterial growth.


If your Morkie is found to have a single shunt, surgical correction can be a good option. Veterinary surgeons use a device called an ameroid constrictor to close the shunt slowly. Once the ameroid constrictor is in place, it takes about three to four weeks to fully close the shunt.

Your Morkie should be able to resume a normal life four to eight weeks after the surgery, though it is important to keep them on a protein-restricted diet during that period. After a follow-up vet visit, if your Morkie’s blood test values return to normal, your pup may return to a normal healthy diet.

Addison’s disease

If your vet thinks Addison’s disease may be involved in your Morkie’s hypoglycemia, they will perform blood work and probably a urinalysis. If they see indications of anemia, abnormally high levels of potassium and urea in the blood, changes in sodium, chloride, or calcium levels, this all points to Addison’s disease. They may also do an electrocardiogram (ECG) to look for changes in your dog‘s heart.

They will then do an adrenocorticotropic hormone (ACTH) stimulation test to make a definite diagnosis. This checks the function of the adrenal glands and lets them know whether or not they are functioning normally.

If Addison’s is confirmed in your Morkie, your veterinarian will prescribe a medication to help correct the hormone deficiency. Because Addison’s disease is not curable, your Morkie will need to take these replacement hormones for the rest of their life. It can take time to find the correct dosage, so you will have to take a trip to the vet often for the first month after diagnosis, so your veterinarian can measure your dog‘s hormone levels. Moving forward, you will then need to bring your dog in once a month for their medication and blood work twice a year.

The good news is, once they are receiving the proper medication, a Morkie with Addison’s disease can go back to living a normal healthy life!

morkie laying on pillow in front of pink background


If your vet thinks insulinoma is a concern, they will want to look at multiple blood samples taken over some time to determine if there is a consistent low glucose concentration. Before these tests, you will need to withhold food from your dog to determine true glucose levels. Your vet can instruct you on the best way to handle these short-term fasts for your dog.

They will then want to do an ultrasound, computed tomography (CT), or magnetic resonance imaging (MRI) to determine the extent of the tumor and how fast it is growing. If your vet feels confident of a diagnosis of insulinoma, they will then do a surgical biopsy to be sure.

If your dog is healthy and the tumor has not spread, surgical removal of the tumor will usually be recommended. The hypoglycemia may be cured by removing the part of the pancreas with the tumor on it. If surgery is not possible, your vet will advise medical management for your pup’s insulinoma. This may include a steroid that stimulates the formation of glucose.

Changing your Morkie’s diet can also be an excellent way to treat your Morkie’s insulinoma. You should check with your vet about the exact diet contents, but generally, you want to feed your Morkie small, frequent amounts of moderate protein, low sugar foods, and complex carbohydrate-rich foods. The most important thing is the frequency of the meals. Smaller, more frequent meals will limit the fluctuations in insulin that cause the hypoglycemic episodes.

How To Help Your Morkie Live a Fulfilling Life With Hypoglycemia

The most important thing in helping your pet Morkie live their best life is to pay close attention to their nutritional needs and to always keep them warm. This is especially true for puppies. Generally, puppies need to be fed four to six times per day.

Remember that hypoglycemia in a Morkie puppy is always an emergency situation. Keep some form of glucose on hand and get to the vet right away if they have an episode! Because Morkies are prone to this condition, you may be looking at some significant vet bills, so make sure you have good pet health insurance.

Otherwise, just give them lots of cuddles and a good amount of moderate exercise, and you and your Morkie will have a wonderful life together!

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